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9(3): 1019-1021, 2014

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THERAPEUTIC EFFECT OF SYNTHETIC PROSTAGLANDIN IN THE

TREATMENT OF PYOMETRA IN BITCHES

BASANTI JENA*, K. SADASIVA RAO, D. DAS1 AND K. C. S. REDDY

Department of Animal Reproduction, Gynaecology and Obstetrics,
College of Veterinary Science, Sri Venkateswara Veterinary University,
Rajendranagar, Hyderabad - 500 030, Andhra Pradesh, INDIA
1
Department of Vety. Pathlogy, CVSc and AH, O.U.A.T. Bhubaneswar - 751 003, Orissa, INDIA
e-mail: drbasantijena@gmail.com
KEYWORDS

ABSTRACT

Pyometra
Treatment
Synthetic prostaglandin
Side effects
Conception rate

The current research was undertaken to study the therapeutic effect of synthetic prostaglandin in treatment of
canine pyometra. Seven bitches were treated with synthetic PGF2 i.e. Cloprostenol sodium at the dose rate of
1g/kg body weight once daily for 7 days subcutaneously along with supportive therapy. The physiological
parameters like rectal temperature and respiration rate, haematological parameters like total leucocyte count
(TLC), neutrophil count and monocyte count and serum biochemical parameters like blood urea nitrogen (BUN),
creatinine, aspartate transaminase (AST), alkaline phosphatase (ALP), mean total protein and globulin level which
were elevated abnormally prior treatment, decreased to normal range after treatment. Other parameters such as
haemoglobin, packed cell volume (PCV), total erythrocyte count (TEC), lymphocyte count and mean alanine
transaminase (ALT) levels, those were at low level before treatment increased to normal range in the treatment
group bitches in comparison with control group. The intensity of side effects was less severe. Two bitches came
to estrus within 2 months of treatment and out of them one conceived on subsequent mating. In six bitches, there
was recurrence of pyometra within 4 months of treatment. Use of cloprostenol sodium in treatment of canine
pyometra in a higher dose rate for a longer duration will reduce rate of recurrence and improve the conception
rate.

Received on :
20.03.2014
Accepted on :
18.07.2014
*Corresponding
author

capabilities.

INTRODUCTION
Pyometra is one of the life threatening diseases affecting the
female reproductive tract in both dogs and cats (Wiebe and
Howard, 2009). It is a hormonally mediated acute or chronic
poly-systemic diestrual disorder that induces high mortality in
bitches if not treated (Singh et al., 2010). The disorder is
assumed to be caused by an exaggerated response to
prolonged or repeated progesterone stimulation (Nelson and
Feldman, 1986). Although ovariohysterectomy is the most
reliable treatment option for pyometra, in young breedable
dogs pharmacological treatment using synthetic
prostaglandins may be used in an attempt to preserve their
breeding potential. The use of prostaglandin F2 alpha (PGF2)
for the treatment of open pyometra has been extremely
encouraging and consistent (Nelson et al., 1982). The
uterotonic action of cloprostenol leads to a significantly faster
decrease in the diameter of the uterine lumen and its luteolytic
action cause a faster drop in mean plasma progesterone
concentration (Fieni, 2006). Side effects such as
hypersalivation, vomiting and diarrhoea are often observed
due to its action on smooth muscles (Gilbert et al., 1989).
However repeated administration of a low dose of
cloprostenol (i.e. 1 g/kg bodyweight) subcutaneously in empty
stomach can eliminate the side effects (Gobello et al., 2003).
The current study was undertaken to know the efficacy of low
dose synthetic PGF2 in treating pyometra affected bitches in
and around Hyderabad without hampering their breeding

MATERIALS AND METHODS

The present work was carried out at Department of Animal
Reproduction, Gynaecology and Obstetrics, CVSc,
Rajendranagar, Hyderabad. Fourteen clinical cases of different breeds in the age group of one to twelve years with known
breeding history and suffering from open type of pyometra
were taken for the study. Bitches were divided into two groups.
Group I bitches were treated only with supportive therapies
(control group). Bitches in Group II, were treated with synthetic PGF2 i.e. cloprostenol sodium (VetmateTM, Vetcare
Divn., Thane, Maharashtra, India) at the dose rate of 1 g/kg
body weight subcutaneously once daily for 7 days with supportive therapies as reported by earlier workers (Gobello et
al., 2003 and Khan et al., 2007). The physiological,
haematological and biochemical parameters were studied
before (0th day) and after treatment (8th day). All the data pertaining to post treatment return to estrus, breeding, conception and recurrence were recorded. Therapeutic efficacy was
assessed in terms of return of abnormal parameters to either
normal or near normal value as compared to the untreated
control group, intensity of side effects and post treatment reproductive status etc. as reported by earlier workers
(Thirumurugan and Rajasundaram, 2011). All bitches of control group and recurred bitches had undergone ovariohysterectomy.
1019

BASANTI JENA et al.,

treated bitches on 8th day of observation that is represented in

Table 1. These findings were in accordance with the
observations of Maity et al. (2009) who preferred carboprost
tromethamine (a synthetic PGF2 analogue) in treatment of
pyometra. Prostaglandin causes localized contractions in the
smooth muscles in the ovary resulting in painful cramps in
women (Sharma and Mehta, 2012). When used in medical
treatment of canine pyometra, it causes cervical dialatation,
myometrial contraction resulting in expulsion of exudates from
uterus and removes progesterone influence on uterus by its
luteolytic effect (Lein, 1986 and Cain, 1998). Synthetic PGF2
analogues such as cloprostenol are more potent in causing
luteolysis and maintaining uterotonic action and therefore
required less frequent administration (Corrada et al., 2006
and Verstegen et al., 2008).

RESULTS AND DISCUSSION

Treatment response
All the seven bitches were successfully treated by using
synthetic PGF2 i.e. cloprostenol sodium at the dose rate of
1g/kg body weight once daily for 7 days subcutaneously
along with supportive therapy. There was 100 per cent recovery
rate observed in the bitches treated with cloprostenol on 8th
day of therapy. However, Fieni (2006) and Khan et al. (2007)
reported 84.4 and 83.33 per cent recovery rate which was
lower than that of the present study.
All the characteristic clinical signs of pyometra like vaginal
discharge, polydipsia, polyuria, lethargy and anorexia
disappeared by 8th day of therapy indicating complete clinical
recovery. Abdominal palpation revealed no palpable uterus
revealing reduced diameter of uterus which was further
confirmed by radiography or ultrasonography. All
physiological parameters like rectal temperature and
respiration rate; haematological parameters like total leukocyte
count (TLC), neutrophil count and monocyte count; serum
biochemical parameters like blood urea nitrogen (BUN),
creatinine, aspartate transaminase (AST), alkaline phosphatase
(ALP), mean total protein and globulin level which were
elevated prior treatment decreased to normal range in the
cloprostenol treated group as compared to control group.
Haematological parameters such as haemoglobin, packed cell
volume (PCV), total erythrocyte count (TEC) and lymphocyte
count; biochemical parameter like alanine transaminase (ALT)
those were at low level before treatment increased to normal
range in the treatment group bitches in comparison with
control group. This resulted in return of normal blood
haematological profile and serum biochemistry in all the

Side effects
After administration of cloprostenol side effects like vomition,
panting, restlessness and hyperpnoea were observed within
15 minutes and all side effects disappeared within 1 to 1.5
hours. However the intensity and severity of side effects were
lower due to low dose of synthetic PGF2 analogue used for
treatment. These findings were in agreement with the findings
of Fieni (2006) and Maity et al. (2009). Side effects were
observed might be due to poor general condition of the bitches
as reported by Fieni (2006) or might due to parasympathetic
action of synthetic prostaglandin derivative resulting in
contraction of smooth muscle of gastrointestinal tract and
tracheo-bronchial tract as reported by Maity et al. (2009).
However, Gobello et al. (2003) reported no adverse side effects
were observed after administration of low dose of cloprostenol.
Though according to previous reports, salivation was the most
common side effect observed after PGF2 therapy, in the

Table 1: Physiological, Haematological and Biochemical parameters

Parameters
Physiological
Parameters
Haematological
parameters

Biochemical
parameters

Rectal temperature (F)

Heart rate (per minute)
Respiration rate (per minute)
Haemoglobin (gram %)
PCV (%)
TEC ( 106/L)
MCV (fl)
MCH (pg)
MCHC (%)
TLC ( 103/L)
Neutrophil (%)
Lymphocyte (%)
Monocyte (%)
Eosinophil (%)
BUN (mg/dL)
Creatinine (mg/dL)
AST (U/L)
ALT (U/L)
ALP (U/L)
TP (g/dL)
Albumin (g/dL)
Globulin (g/dL)
Total Bilirubin (mg/dL)

Before treatment (0th day)

Group I
Group II

After treatment (8th day)

Group I
Group II

102.830.28
112.004.00
29.571.15
11.00.32
33.830.92
5.480.17
66.880.52
21.440.32
31.480.27
33.277.74
76.861.06
11.140.94
9.860.51
2.140.40
26.281.47
2.100.08
49.141.24
28.282.09
153.435.83
7.940.27
2.910.09
5.030.27
0.460.06

103.340.18
109.862.23
32.000.90
10.700.29
33.300.90
5.330.14
66.770.51
21.140.31
31.280.27
34.147.76
78.000.97
10.000.92
10.280.52
1.710.28
29.851.18
2.180.06
50.861.20
24.281.49
158.715.33
8.130.24
2.930.11
5.200.27
0.480.07

103.50.36
107.284.00
29.861.75
11.080.42
34.241.18
5.510.21
66.440.77
21.410.28
31.300.28
36.639.58
79.571.02
8.860.74
9.000.31
2.570.29
24.281.67
2.060.09
48.711.34
25.001.92
154.715.77
8.100.39
2.930.13
5.170.29
0.430.07

N.B. Group I: Untreated control group (n=7) Group II: Treatment group (n=7)

1020

102.310.27
105.712.34
24.570.92
12.370.28
37.980.97
6.180.14
67.960.51
21.600.28
31.460.27
14.312.16
69.860.63
20.280.42
7.430.20
2.430.20
19.280.36
1.800.05
42.280.81
31.001.72
137.575.21
7.130.16
3.170.04
3.950.17
0.400.05

THERAPEUTIC EFFECT OF SYNTHETIC PROSTAGLANDIN

present study it was not observed might be due to the

administration of Atropine sulphate 10-15 minutes prior to
administration of PGF2 as reported by Lein et al. (1989).
Withholding food and water supply to the bitches 4-6 hours
prior to administration of PGF2, use of Atropine sulphate
and providing mild walk to bitches after PGF2 injection were
practised as recommended by Reddy et al. (2010) who used
cloprostenol for terminating pregnancy. All these minimized
the side effects by facilitating early metabolism and excretion
of PGF2 end product.

REFERENCES
Cain, J. L. 1998. Drugs used to treat reproductive disorders. Vet.
Clin. North. Am. 28: 395-396.
Corrada, Y., Arias, D., Rodrguez, R., Tortora, M. and Gobello, C.
2006. Combination dopamine agonist and prostaglandin agonist
treatment of cystic endometrial hyperplasia-pyometra complex in the
bitch. Theriogenology. 66: 1557-1559.
Fieni, F. 2006. Clinical evaluation of the use of aglepristone, with or
without cloprostenol, to treat cystic endometrial hyperplasia-pyometra
complex in bitches. Theriogenology. 66: 1550-1556.

Recurrence

Gilbert, R. O., Nothling, J. O. and Oettle, E. E. 1989. A retrospective

study of 40 cases of canine pyometra-metritis treated with prostaglandin
F2 and broad-spectrum antibacterial drugs. J. Rep. Fer. S. 39: 225229.

Though complete clinical recovery was observed in all the

bitches on 8 th day of treatment, in six bitches there was
recurrence of pyometra within 4 months of treatment. There
was recurrence of pyometra in one bitch within one week of
end of therapy; another two bitches recurred within two weeks
of therapy and other three showed recurrence of pyometra
within 2 months of end of therapy. Recurrence rate was found
to be 85.72 per cent in the cloprostenol treated group. All
health parameters shifted towards abnormal range with
externally visible clinical signs of pyometra in the recurred
bitches. However, Renton et al. (1993) reported that the range
of recurrence for bitches treated only with PGF2 was from 10
to 77 per cent. Higher incidence of recurrence in the present
study might be due to the fact that the uterotonic effect of
PGF2 did not reverse the disease permanently and many
dogs may had a decrease in clinical signs towards subclinical
levels which then became undetectable as reported by Gobello
et al. (2003). All the recurred bitches had undergone
ovariohysterectomy.

Gobello, C., Castex, G., Klima, L., Rodryguez, R. and Corrada, Y.

2003. A study of two protocols combining aglepristone and
cloprostenol to treat open cervix pyometra in the bitch.
Theriogenology. 60: 901-908.
Khan, L. A., Raghuwanshi, D. S., Vhora, S. C. and Utage, S. G. 2007.
Efficacy of certain therapeutic regimens in canine pyometra. Indian J.
Anim. Rep. 28: 49-52.
Lein, O. H. 1986. Prostaglandin therapy in small animal reproduction.
In: Kirk Current Veterinary therapy IX. Philadelphia,WB Saunders
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Lein, D. H., Concannon, P. W., Hornbuckle, W. E., Gilbert, R. A.,
Glendening, J. R. and Dunlap, H. L. 1989. Termination of pregnancy
in bitches by administration of Prostaglandin F2. J. Rep. Fer. S. 39:
231-240.
Maity, S., Sarkar, S. and Saha, T. 2009. Efficacy of Carboprost
Tromethamine therapy in canine pyometra. Indian. Vet. J. 86: 730731.
Nelson, R. W., Feldman, E. C. and Stabenfeldt, G. H. 1982. Treatment
of canine pyometra and endometritis with prostaglandin F 2. J.
American Veterinary Medical Association. 181: 889-903.

Post treatment reproductive status

In the cloprostenol treated group, two bitches came to estrus
within 2 months of treatment which were subsequently mated.
Ultrasonographically, one bitch was confirmed to be pregnant.
Conception rate was found to be 14.28 per cent in this group.
This finding was lower than that of the reports of Maity et al.
(2009) who reported 50 per cent conception rate after using
carboprost tromethamine for treatment of pyometra which
might be due to lower dose of cloprostenol used.

Nelson, R. W. and Feldman, E. C. 1986. Pyometra. Veterinary Clinics

of North America: Small Animal Practice 16: 561-576.
Reddy, K. R. C., Rao, K. S., Raju, K. G. S., Raghavender, K. B. P. and
Reddy, A. G. 2010. Therapeutic efficacy of Mifepristone, cabergoline
and cloprostenol for termination of pregnanacy in bitches. Indian J.
Anim. Rep. 31: 19-22.
Renton, J. P., Boyd, J. S. and Harvey, M. J. A. 1993. Observations on
the treatment and diagnosis of open pyometra in the bitch (Canis
familiaris). J. Rep. Fer. S. 47: 465-469.

CONCLUSION

Sharma, S. and Mehta, P. 2012. Negative impact of fenoterol, a

myometrial relaxant on the histo-architecture of the mice ovary. The
Ecoscan. 1: 179 -184.

All the seven bitches recovered from pyometra temporarily by

the use of synthetic PGF2 i.e. cloprostenol sodium at the dose
rate of 1g/kg body weight once daily for 7 days
subcutaneously along with supportive therapy. The intensity
of side effects was less severe due to low dose used. Though
all physiological, haematological and biochemical parameters
in the seven treated bitches returned to normal range at the
end of treatment, again all the parameters shifted towards
abnormality immediately after stopping the treatment in the
recurred bitches. Two bitches came to estrus within 2 months
of treatment and out of them one conceived on subsequent
mating. In six bitches there was recurrence of pyometra within
4 months of treatment. It is recommended to use cloprostenol
sodium in treatment of canine pyometra in a higher dose rate
for a longer duration which will reduce rate of recurrence and
improve the conception rate.

Singh, K. P., Singh, B., Singh, J. P., Singh, S. V., Singh, P. and Singh,
H. N. 2010. Diagnostic and therapeutic management of pyometra in
bitches. Intas Polivet. 11: 86-87.
Thirumurugan, K. and Rajasundaram, R. C. 2011. Efficacy of
antiprogestin (aglepristone) and prostaglandin f (cloprostenol) in
treatment of 2 open cervix pyometra in bitches J. Indian Veterinary
Association. 9: 38-40.
Verstegen, J., Dhaliwal, G. and Onclin, K. V. 2008. Mucometra,
cystic endometrial hyperplasia, and pyometra in the bitch: Advances
in treatment and assessment of future reproductive success.
Theriogenology. 70: 364-374.
Wiebe, V. J. and Howard, P. 2009. Pharmacologic advances in canine
and feline reproduction. Topic in companion animal medicine. 24:
71-99.

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